BTECH Transcript Request Form

BTECH Transcript Request Form
- Processing time for transcripts & certificates is 3 to 5 business days
- Transcripts are $3 per copy due with request
- Certificates are $5 per copy due with request
- Certificates and Transcripts are sent via USPS, no digital copies at this time
- All tuition/fees must be paid in full
Personal Information
Full Legal Name:*

First NameMiddle NameLast Name
Maiden Name:
Last Name
BTECH Student ID (if known):
Last 4 digits of SSN*
Birthdate*

MonthDayYear
I am requesting this transcript for:*

High school creditPersonal record of certificate courses completed
If you are a current high school student enrolled in a public school your BTECH high school credit will be reflected on your home high school transcript. Contact your home high school for more information. You do not need to complete this transcript request.

If you are a homeschool or out-of-state student, continue with the request.
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Can we update your information if it is different from what is currently in our system?

YesNo

Recipient Information
Delivery Method:*

Mail to HomePick up from BTECHE-mail (unofficial transcripts only)Mail to Other School/Business (provide information below)Send to a BTECH Department
School or Business Name*
Recipient Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Do you need a file attached with your transcript? (Transcript Matching Form, etc.)

YesNo
Upload file here:

Cancelof
Authorized person to pick-up transcript.
Picture ID is required at time of pick-up.
Email (Unofficial transcripts only)
If different from the one entered above.
BTECH Department Name
Fax - : (Institution name, attention to, fax number, etc.) - Unofficial ONLY
Do you need an additional address?

YesNo
2nd Recipient Name*
2nd Recipient Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Comments:

What type of request are you requesting? *

Official transcript

Enter description

$3.00 Quantity

Unofficial Transcript (email only)

Enter description

$ Free Quantity

Certficate

Enter description

$5.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Release and Notification
RELEASE ACKNOWLEDGEMENT: I authorize the release of my academic records to the third parties specified on this form. I also approve the delivery method indicated above.
Signature:*

Clear
Date:*

MonthDayYear
How would you like to be notified that your request has been completed/is ready?*

e-mailText messagePhone call
Should be Empty:

Personal Information